Provider Demographics
NPI:1215543848
Name:BENEVOLENCE HOME SERVICES, LLC
Entity Type:Organization
Organization Name:BENEVOLENCE HOME SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-304-0296
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR STE 300
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5709
Mailing Address - Country:US
Mailing Address - Phone:708-304-0297
Mailing Address - Fax:708-248-1130
Practice Address - Street 1:1 WESTBROOK CORPORATE CTR STE 300
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5709
Practice Address - Country:US
Practice Address - Phone:708-304-0297
Practice Address - Fax:708-248-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE